W Haase

St. Vincent'S Hospital Karlsruhe, Carlsruhe, Baden-Württemberg, Germany

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Publications (5)12.85 Total impact

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    ABSTRACT: Radiotherapy of benign diseases is controversial and rarely applied in Anglo-American countries, whereas in other parts of the world it is commonly practiced for several benign disorders. Similar to a European survey, a patterns of care study was conducted in Germany. Using a mailed questionnaire, radiation equipment, treatment indication, number of patients, and treatment concepts were assessed in 1994, 1995, and 1996 in 134 of 152 German institutions (88%): 22 in East and 112 in West Germany; 30 in university hospitals and 104 in community hospitals. Average numbers of each institution and of all institutions were analyzed for frequencies and ratios between regions and among institutions. Radiation treatment concepts were analyzed. A mean of 2 (range 1-7) megavoltage and 1.4 (range 0-4) orthovoltage units were available per institution; 32 institutions (24%) had no orthovoltage equipment. A mean of 20,082 patients were treated annually: 456 (2%) for inflammatory diseases (221 hidradenitis, 78 local infection, 23 parotitis; 134 not specified) 12,600 (63%) for degenerative diseases (2711 peritendinitis humeroscapularis, 1555 epicondylitis humeri; 1382 plantar/dorsal heel spur; 2434 degenerative osteoarthritis; 4518 not specified); 927 (5%) for hyperproliferative diseases (146 Dupuytren's contracture, 382 keloids; 155 Peyronie's disease; 244 not specified); 1210 (6%) for functional disorders (853 Graves' orbitopathy; 357 not specified); and 4889 (24%) for other disorders (e.g., 3680 heterotopic ossification prophylaxis). In univariate analysis, there were geographic (West vs. East Germany) differences in using radiation therapy (RT) for inflammatory and degenerative disorders, and institutional differences (university versus community hospitals) in using RT for hyperproliferative and functional disorders (p < 0.05). The prescribed dose concepts were mostly in the low dose range, <10 Gy but varied widely and inconsistently within geographic regions and institutions. Radiation therapy is a well-accepted and frequently practiced treatment for several benign diseases in Germany; however, there are significant geographic and institutional differences. As the number of orthovoltage units decreases, an increasing patient load will demand more megavoltage units, which may compromise the cost-effectiveness of this treatment. Only 4% of all clinical institutions have been involved in controlled clinical trials. To maintain a high level of RT service to other disciplines, RT treatment guidelines, quality control, and continuing medical education are required.
    International Journal of Radiation OncologyBiologyPhysics 04/2000; 47(1):195-202. · 4.52 Impact Factor
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    ABSTRACT: The plenty options and high quality of radiation therapy for non-malignant disorders is not well known outside the field of radiology. It is necessary to transfer this information to cooperating general practitioners, surgeons, orthopedics and other specialists. To warrant quality assurance and quality control and to allow a uniform performance of radiotherapy of non-malignant conditions, general guidelines and recommendations according to the German Working Group of Scientific Medical Societies are useful. This paper summarizes the essential aspects of radiotherapy for non-malignant diseases: indication of, informed consent for, documentation and conduct of radiation therapy for non-malignant diseases using orthovoltage equipment and specific recommendations for follow up examinations. Radiotherapy concepts for non-malignant diseases are summarized.
    Rontgenpraxis 02/2000; 52(10-12):371-7.
  • Source
    International Journal of Radiation Oncology Biology Physics - INT J RADIAT ONCOL BIOL PHYS. 01/2000; 48(3):240-240.
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    ABSTRACT: Radiation therapy of benign diseases is controversially discussed and rarely applied in Anglo-American countries, while in other parts of the world, especially Central and East Europe, it is commonly practised for several benign disorders. Similar to the European Society of Therapeutic Radiology and Oncology survey, a patterns of care study was performed in Germany. A questionnaire was mailed in 3 years (1994, 1995, 1996) to all radiation facilities in Germany, which assessed equipment, indications, number of patients and treatment concepts. A total of 134 (88%) institutions returned all requested data: 22 in East and 112 in West Germany; 30 in university and 104 in community/private hospitals. The average data of each institution and of all institutions were analyzed for frequencies and ratios between different regions and institutions. A mean of 2 (range 1 to 7) megavoltage (Linac/Cobalt 60) and 1.4 (range 0 to 4) orthovoltage units were available per institution; 32 (24%) institutions had no orthovoltage equipment. A mean of 20,082 patients were treated per year: 456 (2%) for inflammatory diseases (221 hidradenitis, 78 nail bed infection, 23 parotitis, 134 not specified), 12,600 (63%) for degenerative diseases (2,711 peritendinitis humeroscapularis, 1,555 epicondylitis humeri, 1,382 heel spur, 2,434 degenerative osteoarthritis, 4,518 not specified), 927 (5%) for hypertrophic diseases (146 Dupuytren's contracture, 382 keloids, 155 Peyronie's disease, 244 not specified), 1,210 (6%) for functional disorders (853 Graves' orbitopathy, 357 not specified), and 4,889 (24%) for other disorders (e.g. 3,680 heterotopic ossification prophylaxis). In univariate analysis, there were significant geographical (West vs East Germany) differences in the use of radiotherapy for inflammatory and degenerative disorders and institutional differences (university vs community/private hospitals) in the use of radiotherapy for hypertrophic and functional disorders (p < 0.05). The prescribed dose concepts were mostly in the low dose range (< 10 Gy), but varied widely and inconsistently within geographic regions and institution types. Radiotherapy is a well accepted and frequently practised treatment for several benign diseases in Germany, however, there are significant geographical and institutional differences. As the number of orthovoltage units decreases, an increasing patient load is in demand of more megavoltage units, which may compromise the cost-effectiveness of this treatment. Only 4% of all clinical institutions are involved in controlled clinical trials. To maintain a high level of radiotherapy service to other disciplines, radiotherapy treatment guidelines, quality control and continuing medical education are required.
    Strahlentherapie und Onkologie 11/1999; 175(11):541-7. · 4.16 Impact Factor
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    ABSTRACT: HINTERGRUND. Der Einsatz der STrahlentherapie bei gutartigen Erkrankungen wird kontrovers diskutiert und zum Teil kaum noch praktiziert, zum Beispiel im angloamerikanischen Raum. In anderen Teilen der Welt, besonders Zentral- und Osteuropa, wird die Strahlentherapie routinemäßig eingesetzt. Analog zur European Society of Therapeutic Radiology and Oncology (ESTRO) wurde eine systematische Analyse zum Stand der Radiotherapie bei gutartigen Erkrankungen in Deutschland durchgeführt. METHODIK. 1994, 1995 und 1996 wurde an alle strahlentherapeutischen Institutionen in Deutschland ein Fragebogen verschickt, mit dem technische Ausstattung, Indikationsspektrum, Patientenzahl und Therapiekonzepte bei gutartigen Erkrankungen erhoben wurde. 134 (88%) Institutionen (22 in Ost-, 112 in Westdeutschland; 30 in Universitäts-, 104 in öffentlichen/privaten Krankenhäusern) beantworteten alle Fragen. Die Häufigkeiten und Durchschnittwerte pro Institution und über alle Institutionen hinweg wurden hinsichtlich geographischer Region und Krankenhaustyp analysiert. ERGEBNISSE. Im Durchschnitt standen zwei (Spanne 1 bis 7) Linearbeschleuniger/Kobaltgeräte und 1,4 (Spanne 0 bis 4)Orthovolgeräte pro Institution zur Verfügung 32 (24%) besaßen kein Orthovoltgerät. Pro Jahr wurden im Mittel 20082 Patienten behandelt: 456 (2%) wegen Entzündungen (221 Hidradenitis, 78 Panaritium, 23 Parotitis, 134 nicht differenziert), 12600 (63%) wegen degenerativer Erkrankungen (2711Peritendinitis humeroscapularis, 1555 Epicondylopathia humeri, 1382 Fersensporn, 2434 arthrotische Erkrankungen, 4518 nicht differenziert), 927 (5%) wegen hypertrophischer Erkrankungen (146 Morbus Dupuytren, 382 Keloide, 155 Induration penis plastica, 244 nicht differenziert), 1210 (6%) wegen funktioneller Erkrankungen (853 endokrine Orbitopathi, 357 nicht differenziert), 4889 (24%) wegen anderer (zum Beispiel 3680 Prophylaxe heterotoper Ossifikationen). In univariater Analyse zeigten sich signifikante geographische Unterschiede (westliche vs. östliche Bundesländer) bei entzündlichen und degenerativen Erkrankungen und institutionelle Unterschiede (Universitäts- vs. Versorgungskrankenhäuser) bei hypertrophischen und funktionellen Erkrankungen (p < 0,05). Die meisten Therapiekonzepte ware im Niedrigdosisbereich (< 10 Gy) angelegt, schwankten aber im Detail unsystematisch und in weiten Grenzen. SCHLUSSFOLGERUNG. Die Strahlentherapie ist eine gut akzeptierte, oft eingesetzte Therapie bei gutartigen Erkrankungen in Deutschland, doch bestehen große geographische und institutionelle Unterschiede. Der wachsende Mangel an Orthovoltgeräten erhöht das Patientenaufkommen an Hochvolgeräten, was die Kosteneffektivität der Methode beeinträchtigen kann. Nur 4% aller Institutionen beteiligen sich an klinischen Studien. Um den hohen Standard der Therapie zu sicher, sind Therapieleitlinien, Kriterien zur Qualitätssicherung und kontinuierliche Bemühungen in der Aus- und Weiterbildung nötig.
    Strahlentherapie und Onkologie 01/1999; 175(11):541-547. · 4.16 Impact Factor

Publication Stats

71 Citations
12.85 Total Impact Points

Institutions

  • 1999–2000
    • St. Vincent'S Hospital Karlsruhe
      Carlsruhe, Baden-Württemberg, Germany
    • Alfried Krupp Krankenhaus
      Essen, Lower Saxony, Germany